Severe weight loss and in particular muscle wasting is a serious phenomenon that occurs on a broad scale in patients suffering from diseases, disorders and trauma. Muscle wasting (abbreviated as MW) in chronic disease is defined as an involuntary loss of body weight of more than 5% within one month. If loss of lean body mass (abbreviated as LBM) occurs at a more gradual rate but during a longer period, the inventors refer to chronic muscle wasting (abbreviated as CMW), in particular if more than 10% of body weight is lost in a period of 6 months. MW is typically observed during recovery of trauma or surgery. CMW is typically observed in severe diseases such as cancer, AIDS, COPD, diabetes mellitus and heart failure. The rate of muscle wasting is associated with increased morbidity and mortality. The cause of muscle wasting as a result of a disease is thought to be multifactorial. Muscle wasting can also be caused by malnourishment, in particular protein-energy malnourishment. In particular the latter type of malnourishment can be treated or prevented by providing extra protein or energy as proposed in EP 0721742.
Sarcopenia (abbreviated as SP) is the involuntary decline in lean muscle mass, strength and function, which occurs with ageing. SP increases the risk of loss of functional capacity in the elderly, which is not necessarily related to disease.
Dietary fibres are frequently used to initiate weight loss. Dietary fibre lowers postprandial glucose levels in blood and has a satiating effect. Therefore, administration of substantial amounts of dietary fibre is not normally recommended in cases of malnutrition, weight loss and muscle wasting. Dietary fibre has also been included in clinical nutrition for influencing colonic flora and specific fibres or mixtures thereof have been claimed to decrease rate of systemic infections, e.g. in WO 02/26242, increase specific immune-related parameters, e.g. in EP-B 1105002, or decrease growth rate of selected tumours in animals, e.g. in Taper H., J. Nutr., 129 (1999), 1488-1491.
Many types of dietary fibre have been used in the manufacture of nutritional products. Several of them strongly increase viscosity, others have a bad solubility or produce a sand-like feeling when present in the mouth. Thus, there is a need for nutritional products, which can be readily consumed by persons suffering from muscle wasting or chronic muscle wasting, and which combat or prevent muscle wasting without having the disadvantages of prior art products, such as a high viscosity of liquid drinks.
WO 2004/026294 discloses the use of a mixture of free essential amino acids including leucine for improving the effects of tumour-induced weight loss. The mixture can be combined with further components such as intact protein, ω-3 fatty acids and soluble fibre such as hydrolysed guar gum.
U.S. Pat. No. 6,387,883 teaches treatment of cachexia and anorexia by administration of ω-3 fatty acids, branched-chain amino acids, and further components possibly including dietary fibre.
U.S. 2005/153019 is concerned with stimulating body protein synthesis by providing a composition containing whey protein, ω-3 fatty acids, carbohydrates, vitamins, etc. The composition may further contain prebiotic fibre, such as fructo-oligosaccharides, for promoting growth of bifidobacteria, but such compositions are not further illustrated.
U.S. Pat. No. 5,444,054 teaches a method of improving nutritional status in case of ulcerative colitis or colic inflammation, using a combination of the ω-3 fatty acids EPA and DHA, and indigestible carbohydrates, such as gum Arabic and fructo- and xylo-oligosaccharides.